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Dr. Shawn Smit:  Impaired Physician

Borderline Violence, Adversarial Dynamic

Dr. Smit:  Idylwyld Medical Centre

Dr. Shawn Smit

Family Physician
Idylwyld Medical Centre
1216 Idylwyld Drive North
Saskatoon, Canada

Emigrated from South Africa

Medical School: University of Pretoria
(Independent verification not possible)

College of Physicians and Surgeons:
Dr. Shawn Smit Profile

Easy Access Creates Risk

Physicians have easy and surreptitious access to drugs of abuse, either when administering treatment to patients, or by self-prescription. There are consequences to easy access: Over their practice lifetime, 8% - 12% of physicians will experience a substance related problem. This is the most common reason for disciplinary action by State Medical Boards in the USA.

The impaired physician often retains the ability to protect his or her practice performance at the expense of other dimensions of life. Prior to career impairment – long before it becomes obvious – the MD often displays problems in social, family, or emotional realms. Frequently, substance abuse pre-dates admission to medical school.

No single sign signifies impairment. Collectively, however, the signs may define a pattern, warning of a potential problem. Colleagues are required to immediately report any good faith suspicion or concern about an impaired professional. To the extent allowed by law, the information is treated confidentially. Good faith reports of possible impairment can be made without fear of retaliation.

Recognizing Impairment:  Behavioral and Career Clues

Dr. Shawn Smit Behavioral Clues
Outbursts of anger
Incongruous expressions of libido
Poor memory, poor concentration
Declining performance in career
  Drinking or driving under the influence (DUI)
Dr. Shawn Smit Career Warning Signs
Neglect of patients or duties
Inappropriate treatment or orders
Patient complaints increase
  Excessive absenteeism
  Sleeping or dozing on duty
  Appointments or schedule disorganized
  Hard to locate; does not respond to pages or calls

Patient Log:  May 21, 2013

Dr. Shawn Smit
GP Dr. Shawn Smit
Idylwyld Clinic, Saskatoon

Family physician Dr. Shawn Smit practices at the Idylwyld Medical Centre in Saskatoon, Canada. Recently over a two-year period, Dr. Smit maneuvered a complete role reversal with me in our doctor-patient relationship. I shouldered the workload because Dr. Smit could not, or would not, do the work himself. If I didn't turn up information and ideas, then my medical care stood still.

Dr. Smit enjoys the role of being a doctor, and the power it confers. Unfortunately, he has no affinity for science. He is bored by science, indifferent to it. His photo (left) portrays the resulting fear and ennui: Dr. Shawn Smit is perched on his chrome chair, his posture dispirited, his face a portrait of utter misery because he cannot wrap his mind around the technical topic depicted on the research abstract or textbook page I just handed him.

His misery has naught to do with how patients conduct themselves. For myself, I routinely appeased and placated Dr. Smit, offering compassion and several thank-you's per visit. This route became necessary to fend off his borderline violence.

The only question that matters is whether you continue to climb the learning curve.
~ Georgena Sil

At my appointment today at Idylwyld Clinic, Dr. Smit showed a sudden preoccupation with patients trusting him. In a tone that alternately browbeat and wheedled, Dr. Smit reiterated this theme, claiming that when a patient looks up topics on the internet, it means the patient doesn't trust what he says.

He trolled that fishing line several times during this consult. He also fished for compliments: In a loud, self-absorbed voice he asked me whether I believed he had adequate knowledge. I replied: The only question that matters is whether you continue to climb the learning curve. I added: As a physicist, I place the same requirement on myself.

There is a dichotomy:  Dr. Smit rages when I read medical subjects on the internet, then turns around and simultaneously holds out his hand for the next installment of print-outs from my internet search for information to guide what to do next.

Dr. Smit's anger is really angst: He fears that patients will learn from independent sources that his medical advice – except on the most trivial of topics – is misinformed. Dr. Smit also suffers memory problems so severe that almost everything he says is the opposite of what the textbooks say – not hard to discover in this era of the internet.

In my case, his wish for blind trust focused on two chief areas:

1.Issue: Statins are a class of medicine used to treat high-cholesterol. Dr. Shawn Smit launched a months-long campaign to persuade me that statin side-effects are increasingly seen as exaggerated.
Rebuttal: The opposite is true. The FDA increasingly recognizes statin risks. The list of adverse events now includes exertional fatigue, Type 2 diabetes, myopathy, rhabdomyolysis (a potentially fatal muscle disease), and CNS side-effects. The FDA at first believed the risks were impossible, until research into glial cells, for example, showed how statins can induce cognitive deficit in the brain. The FDA stopped denying the risks, and now acknowledge and publish cautions.
2.Issue: Lipase is a pancreatic enzyme. Dr. Shawn Smit wanted to persuade me that Lipase can be zero without causing symptoms.  Our Saskatoon blood-test laboratory sets the normal range for Lipase at 22–51 Units/Liter.  But Smit claims we can act as if the normal range for Lipase actually begins at zero because some labs in the world begin their normal range at zero.
Rebuttal: Lipase measured in a fasting patient can be low, but 30 minutes after a meal this digestive enzyme should peak. On a graph you should see a linear rise above the basal (base or fasting) value. Failure of Lipase to rise post-meal signifies pancreatic insufficiency – a serious condition. Our body relies on Lipase to digest fats, specifically to split triglycerides into usable fatty acids.
It is vital to use the reference range (normal range) printed on your own lab sheet. Labs customize their own reference range for each test. The many labs across the country buy diverse brands of machinery, mix the blood sample with different reagents, and follow variants of test protocols. In result, reference ranges may vary widely between labs. It is appallingly negligent for a doctor to swap his local lab's normal range for some other range that he read on a blog.
When a patient has elevated Cholesterol or Triglyceride levels, the cause is often genetic. One mechanism is mutation of the Lipase gene. Defects in this gene can decrease the rate of Lipase production in the pancreas. A defective gene may also alter the structure of the Lipase molecule, rendering it less active. The quantity and quality of Lipase both matter.

Dr. Shawn Smit:  Boundary Violation

Dr. Shawn Smit
Saskatoon GP Dr. Shawn Smit

During the most intimidating 15 minutes today, Dr. Shawn Smit committed a boundary violation. He usually sits slumped (photo, left). Unexpectedly, his posture became active and rhythmic – vulgar, showing contempt, as if this were a rape of information. The event was at the low end of the abuse spectrum (visual, no touching) but was accompanied by a domineering voice tinged with glee.

The timing was precise: The event occurred over the minutes when he thought he had successfully run a scam on me – telling me that even Hepatobiliary specialists would say low-Lipase doesn't matter.

During previous appointments, I sensed that Dr. Smit got pleasure out of wounding and deceiving people. Today I saw he gets so much pleasure in destruction that his emotions cross the boundary into a sexual charge. [Insight from journalist and author Michael Connelly, source Blood Work.]

The malicious intent so blatant in this appointment left me feeling shell-shocked for three weeks. My sense of betrayal is strong, and lingers longer.

Georgena S. Sil
Saskatoon, Canada
Physicist & Technical Writer
Alumnus: University of British Columbia
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Idylwyld Medical Centre

Idylwyld Medical Centre

Saskatoon, Canada

I settled the matter by answering my own inquiry, as people are apt to do when very much in earnest.

Louisa May Alcott

Hospital Sketches

Graph: Pancreatic enzyme response to a meal

Digestive Pancreatic Enzyme Response to a Regular Meal

Graph:  Typical biphasic pattern of a healthy pancreas.

Peak:  After a Lundh meal, enzyme delivery into the duodenum increases rapidly, reaching a peak within the first hour or even within 20–30 minutes postprandially.

Plateau:  Following peak output, enzyme secretion decreases to almost stable secretory rates at lower levels until about 3 to 4 hours postprandially depending on meal size.

Basal State:  The fasting level is reached again at the end of the digestive period.

Source:  Human Pancreatic Exocrine Response to Nutrients in Health and Disease (British Medical Journal, 2005)

Enzyme output after Lundh meal
for a healthy pancreas

Pancreatic Insufficiency

Chronic Pancreatitis

Exocrine glands secrete through a duct. The exocrine pancreas secretes 3 enzymes through the papilla of Vater into the duodenum:

Amylase digests carbohydrate
Lipase digests fat
Protease digests protein

In health: The pancreas matches the quantity of enzymes it secretes to the quantity of nutrients ingested.

In disease: Pancreatitis typically raises enzyme levels at first. If left untreated, parenchyma tissue can be steadily destroyed until enzyme levels fall below normal.

The exocrine pancreas has a large reserve capacity. Overt malabsorption of nutrients and steatorrhoea are late-stage events. This phase is called Pancreatic Insufficiency.

Causes of Pancreatic Exocrine Insufficiency

  • Loss of Functioning Parenchyma
  • Chronic Pancreatitis
  • Cystic fibrosis
  • Pancreatic resection
  • Pancreatic tumors or carcinoma
  • Intact Parenchyma
  • Obstruction of pancreatic duct
  • Celiac disease
  • Zollinger-Ellison syndrome
  • Enzyme Inactivation
  • Duodenal hyperacidity (affects Lipase)


Letter from Dr. Shawn Smit

By letter dated Feb 3, 2014 Dr. Shawn Smit said: “The patient-physician relationship must be based on trust This can only be done in the context of a satisfactory patient-physician relationship in which both partners participate willingly.”

Affinity Fraud

The Better Business Bureau warns: the phrase ‘Trust me’ is a glaring red flag. It is key to crimes of persuasion which always have this fundamental structure:

  • Motive: The con man seeks a reward that is tangible (money) or intangible (a rush of oxytocin in the brain from joy at deceiving or manipulating people).
  • Victim selection: The con man counts on you needing him to fulfill a specific goal that you have. He is only interested in people who can be turned to believe him without question. He also tests whether you can be controlled (one such test is to defy your protests to see how you react).
  • Executing the con: The con man shows confidence in you. In return, your trust in him grows organically. The mechanism of the fraud is voluntary relinquishment of your decision-making power. The victim is distracted from his own best interests. You cease observing and checking facts.
  • Psychology: An arsenal of ploys keeps you emotionally off-balance. Evasion, always. Eventually, belligerence to intimidate you into compliance.
  • Finale: The con artist betrays the victim's trust, deliberately and by design.

Affinity Fraud is a confidence game where the trust is pre-existing. Honest people particularly succumb to this insidious crime which exploits the natural trust that exists within a group of people who share common interests.

Fiduciary Duty replaces trust in groups where participants have unequal knowledge or power. Your MD has a fiduciary (legal) duty to act solely in your interests. In the doctor-patient relationship, informed consent is required by law, and is the direct antithesis of blind trust.

Copyright © 2008-2019 Georgena Sil. All Rights Reserved.